Hi Group C,
Welcome to Equine SEL sign off blog, 556AVN - Biomechanical assessment and exercise prescription.
In your group, using your allocated scenario, discuss a remedial exercise program appropriate to your case and stage of repair, which would improve locomotion and proprioception. You need to include groundwork and ridden work, explain the concept of "core stability and how this is achieved. Give the pros and cons of the use of lunging, long reining, and the use of training aids, in relation to your case. You all have from now until our next taught session (22.01.21) to contribute to this blog. You must contribute to this blog to get your SEL signed off. Ensure that your entries are based on evidence and that you are reactive to one another to allow a good discussion of the topic. I will be keeping an eye on the blog, but if you have any issues, you should email me. Please ensure that you register your name with your comments so that I know who has written what.
Rosa
Your case study:
You have been referred a 10-year-old, 13.2hh gelding show pony.
On radiographic examination, it was found that T13 to T16 were overriding. This pony was treated by resection of T13 and T15 spinal processes during standing surgery.
Post-surgery, he was box rested and walked in hand 15 minutes per day for 4 weeks. He was then turned out in a small paddock for a further 4 weeks.
It is now 8 weeks post-surgery, and turnout to the normal paddock is being re-introduced. Moderate atrophy of the longissimus bilaterally from T12 to T16 is apparent.
The Veterinary Surgeon has re-examined the pony and has referred for REP to increase core muscle strength and spinal flexibility.
I think some important considerations for this case would be his age, although 10 isn't very old it would be 'middle-aged' and is something to think about when deciding on duration and difficulty of exercises. As he is a show pony, he should have been in relatively good condition fitness wise before surgery, so this will help his recovery time, it shouldn't take as long as it would for a completely unfit pony. However, show ponies can often be overweight or in 'show condition' which could make the rehabilitation a bit harder on him.
ReplyDeleteCaoimhe
When I see core stability I think of the bow and string theory, where the back muscles must engage and work correctly to stabilise the core. So I think through strengthening the epaxial and hypaxial muscles, especially longissimus dorsi, this will result in improved core stability.
ReplyDeleteCaoimhe
Anna
ReplyDeleteDynamic mobilization exercises to increase epaxial muscles and improve flexibility (x5 per week)
- Chin to chest
- Chin to ground
- Chin between forelimbs
- Neck bent round to shoulder and then moving caudally towards the hock
Before long reining the horse could be hand walked over different terrains, so not just on the road or in an arena, it could be walked through long grass or on an uneven surface (although not so uneven the horse could trip) and over poles. This would improve the horses proprioception and would help the reactivation of muscles.
ReplyDeleteLong reining is usually done before lunging so the horse can travel in straight lines. It is a good step up from hand walking as it is fairly similar and starts to ask the horse to lower its neck and to stretch over its back.
Long reining is ideal for this pony because it can't be ridden yet and long reining is similar to riding but just from the ground. So the pony could do transitions within the walk and a change of pace in the walk this will help it stretch over its back and hopefully work into the contact. - Kate d
8 weeks post surgery would be repair phase 4: maturation and remodelling, which is the final stage of repair and can take months (or years). Goals would be to improve balance, coordination and strength and improve proprioception and flexibility. This applies to this case and stage of repair as the goals for the pony are to improve core stability and spinal flexibility through REP.
ReplyDeleteBromiley, M. (2007) Equine Injury, Therapy and Rehabilitation (3rd ed.) Oxford, Blackwell Publishing.
Kate E
Epaxial muscles control local vertebral movements, stabilise the spine and are involved in proprioception. They extend the back and when contracting on one side produce lateral flexion. They also balance the back and prevent hyperflexion.
ReplyDeleteDMEs performed 3 days per week hypertrophied multifidus, but did not hypertrophy longissimus. Do DMEs need to be performed more often to hypertrophy longissimus (pony has atrophied longissimus) or do we need another exercise?
Schultz, R.M. and Elbrond, V.S. (2018) Novel dissection approach of equine back muscles: new advances in anatomy and topography - and comparison to present literature, SPG BioMed, https://www.researchgate.net/publication/329482805_Novel_dissection_approach_of_equine_back_muscles_new_advances_in_anatomy_and_topography_-_and_comparison_to_present_literature
de Oliveira, K. et al (2015) Gymnastic Training and Dynamic Mobilisation Exercises Improve Stride Quality and Increase Epaxial Muscle Size in Therapy Horses, Journal of Equine Veterinary Science https://www.sciencedirect.com/science/article/pii/S0737080615005067
Aerobic training increases cross sectional area of longissimus so perhaps long term goals (maybe once pony is strong enough to be ridden again) would include aerobic exercise to hypertrophy longissimus
DeleteD'Angelis, F et al. (2007) Aerobic Training, But Not Creatine, Modifies Longissimus Dorsi Muscle Composition, Journal of Equine Veterinary Science https://www.sciencedirect.com/science/article/pii/S0737080607000470
They are some interesting and relevant studies you have found, I agree that we need to use exercises which increase the strength of the longissimus dorsi, epaxial muscles, sub-lumbar and abdominals.
DeleteDynamic mobilization exercises such as asking the horse to bend their neck to the side and then eventually moving caudally so the chin reaches the hock. This can be done in hand using food as bait. The pony will probably not be able to reach his hock with his chin to start with so just go to where ever the horse can manage then gradually increase the stretch.
This exercise makes the horse contract the abdominal muscles which, over time strengthens them. The strengthened abdominal muscles will help to stabilize the spine. It also engages the epaxial muscles as well as the multifidus, the deepest layer of spinal muscling which often becomes atrophied after an injury to the back. Research has shown the epaxial muscles to have strengthened and increased in size after 10- to 12 weeks of daily exercises.
http://www.equine-rehab.com/equine-spine/
Anna
DeleteThey're really interesting articles Kate, I think finding more suitable exercises to strengthen the longissimus would be helpful!
ReplyDeleteCaoimhe
Well done to all of you with this one. Some good exercises and considerations discussed. You could have discussed this further in terms of the longer term goals (such as returning to previous activity), maybe mentioning when it would be suitable for the pony to start ridden work. Also with this one the use of training aids once the pony is lunging again could have been discussed, as these would be suitable to encourage engagement of the ventral and dorsal muscular chains, spinal flexion and correct posture. Good use of evidence base, well done. I will sign the 1st Equine REP SEL discussion for Anna, Caoimhe, Kate D and Kate E, on our return to face to face teaching.
ReplyDelete